Georgetown University Medical Center has been a locus of substantial translational and patient-oriented research for many years. In the past notable faculty such as Professor Proctor Harvey (cardiology) and Professor George Schreiner (nephrology) were international leaders in their respective areas. Over the past decade Georgetown has made a major institutional commitment to development of both laboratory-based and patient-oriented research manifested by a quadrupling of laboratory space during that time, development of a number of research programs reflected in this application, and dedication of one floor of the Main Hospital to clinical research. His has been paralleled by a three-fold increase in extramural research funding, with extramural support in fiscal year 1998 reaching 100 million dollars. Extramural support has risen steadily, with funding balanced evenly between laboratory based and patient-oriented research. In 1989 the Clinical Research Center in its present incarnation was opened. Since that time, the level of activity, peer-reviewed support for patient-oriented research, and publication of findings have also been on a steady increase, and this has been particularly evident in the past four years. Novel aspects of CRC research are the excellent programs in cancer therapy, hypertension, aging, Gulf War Syndrome, AIDS and drug safety. Each of these programs is influenced by Georgetown's internationally recognized institutional programs in bioethics. This critical mass of patient-oriented research centered in a Clinical Research Center setting has allowed development of a number of research training and education activities which include efforts at the student, resident, clinical research fellow, and junior faculty levels. This has developed in synergy with funded research training programs in clinical pharmacology and tumor biology, and other training programs that are becoming competitive for funding. With this level of high quality peer-reviewed research, the strong institutional commitment, and the desire to continue our growth in patient-oriented research, we believe the next logical step is a recognized and funded General Clinical Research Center. During the review of this application we look forward to the opportunity to demonstrate our capability in conducting outstanding patient-oriented research at Georgetown University Medical Center.